Abstract
Background
The present study was performed to determine whether thyroidectomy patients undergoing general anesthesia provided with a laryngeal mask airway (LMA) have a lower risk of voice-related complications and laryngopharyngeal symptoms than those undergoing endotracheal intubation (ETI).
Materials and methods
In a prospective, double-blinded, randomized clinical trial, we studied 64 patients undergoing elective thyroid lobectomy between July 2013 and February 2014. Acoustic analyses were performed preoperatively and at 48 h and 2 weeks postoperatively. The voice handicap index (VHI), M.D. Anderson dysphagia index (MDADI), and laryngopharyngeal symptom score (LPS) were determined preoperatively and at 24 h, 48 h, 1 week, and 2 weeks post-thyroidectomy.
Results
In acoustic analysis, jitter, shimmer and noise-to-harmonic ratio showed significantly better results in the LMA group than the ETI group 48 h after surgery, but there was no difference at 2 weeks. The incidence of postoperative lower-pitched voice in the LMA group was also significantly lower than that in the ETI group. In the LMA group, the VHI, MDADI, and LPS were better compared to those in the ETI group at 24 h postoperatively, and improved to the preoperative state within 1 week. However, those in the ETI group remained poorer than the preoperative values 1 week after surgery.
Conclusions
Use of the LMA in general anesthesia for thyroid surgery has advantages over the ETI in decreasing patients’ subjective and objective voice symptoms, reducing the duration of symptoms, and relieving the laryngopharyngeal symptoms.
Similar content being viewed by others
References
Bhattacharyya N, Fried MP (2002) Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngol Head Neck Surg 128:389–392
McIvor NP, Flint DJ, Gillibrand J et al (2000) Thyroid surgery and voice-related outcomes. Aust NZ J Surg 70:179–183
Aluffi P, Policarpo M, Cherovac C et al (2001) Post-thyroidectomy superior laryngeal nerve injury. Eur Arch Otorhinolaryngol 258:451–454
Keilmann A, Hulse M (1992) Dysphonia following strumectomy with normal respiratory movement of the vocal cords. Folia Phoniatr 44:261–268
Page C, Zaatar R, Biet A et al (2007) Subjective voice assessment after thyroid surgery: a prospective study of 395 patients. Indian J Med Sci 61:448–454
Debruyne F, Ostyn F, Delaere P et al (1997) Acoustic analysis of the speaking voice after thyroidectomy. J Voice 11:479–482
Jones MW, Catling S, Evans E et al (1992) Hoarseness after tracheal intubation. Anaesthesia 47:213–216
McHardy FE, Chung F (1999) Postoperative sore throat: cause, prevention and treatment. Anaesthesia 54:444–453
Mencke T, Echternach M, Kleinschmidt S et al (2003) Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial. Anesthesiology 98:1049–1056
Biro P, Seifert B, Pasch T (2005) Complaints of sore throat after tracheal intubation: a prospective evaluation. Eur J Anaesthesiol 22:307–311
Combes X, Schauvliege F, Peyrouset O et al (2001) Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology 95:1120–1124
Radu AD, Miled F, Marret E et al (2008) Pharyngo-laryngeal discomfort after breast surgery: comparison between orotracheal intubation and laryngeal mask. Breast 17:407–411
Bennett J, Petito A, Zandsberg S (1996) Use of the laryngeal mask airway in oral and maxillofacial surgery. J Oral Maxillofac Surg 54:1346–1351
Shah EF, Allen JG, Greatorex RA (2001) Use of the laryngeal mask airway in thyroid and parathyroid surgery as an aid to the identification and preservation of the recurrent laryngeal nerves. Ann R Coll Surg Engl 83:315–318
Ryu JH, Yom CK, Park DJ et al (2014) Prospective randomized controlled trial on the use of flexible reinforced laryngeal mask airway (LMA) during total thyroidectomy: effects on postoperative laryngopharyngeal symptoms. World J Surg 38:378–384. doi:10.1007/s00268-013-2269-1
Park JO, Shim MR, Hwang YS et al (2012) Combination of voice therapy and antireflux therapy rapidly recovers voice-related symptoms in laryngopharyngeal reflux patients. Otolaryngol Head Neck Surg 146:92–97
Chen AY, Frankowski R, Bishop-Leone J et al (2001) The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg 127:870–876
Nam IC, Bae JS, Shim MR et al (2012) The importance of preoperative laryngeal examination before thyroidectomy and the usefulness of a voice questionnaire in screening. World J Surg 36:303–309. doi:10.1007/s00268-011-1347-5
Mupparapu M, Vuppalapati A (2005) Ossification of laryngeal cartilages on lateral cephalometric radiographs. Angle Orthod 75:196–201
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chun, BJ., Bae, JS., Lee, SH. et al. A Prospective Randomized Controlled Trial of the Laryngeal Mask Airway Versus the Endotracheal Intubation in the Thyroid Surgery: Evaluation of Postoperative Voice, and Laryngopharyngeal Symptom. World J Surg 39, 1713–1720 (2015). https://doi.org/10.1007/s00268-015-2995-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-015-2995-7